Sexual Shaming and Violent Commands in Schizophrenia: Cultural Differences in Distressing Voices in India and the United States

Abstract

\n In a side-by-side comparison, we found that the voices of patients who met the criteria for schizophrenia in Chennai, Tamil Nadu, India and in San Mateo, CA, United States were different. Both groups heard commands. In San Mateo, those commands were often violent, but in Chennai, commands often seemed more to do with everyday activities. Both groups heard voices that spoke about sexual activities. In Chennai, participants reported more voices that talked about sex, and they often experienced intense shame and guilt around these sexual voices. In San Mateo, sexual voices seemed to have less shaming content and were more often described with enjoyment. In San Mateo, voices were also more violent in general. We suggest that the content of voices may reflect local cultural ideas about voices and local cultural responses to specific features of the voice-hearing experience.